Provider Demographics
NPI:1518710631
Name:USSIN, LAKEISHA SHANTA
Entity Type:Individual
Prefix:
First Name:LAKEISHA
Middle Name:SHANTA
Last Name:USSIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 CLEARY AVE APT 13
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-5742
Mailing Address - Country:US
Mailing Address - Phone:504-914-5522
Mailing Address - Fax:
Practice Address - Street 1:3205 CLEARY AVE APT 13
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5742
Practice Address - Country:US
Practice Address - Phone:504-914-5522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service